License holder summary

CAROL BRYAN BALLOU is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for CAROL BRYAN BALLOU is 1100 WEST SIXTH AVE, GARY IN 46402. This licensed professional license is not current. The license was granted 09/01/1982 and expired on 12/31/1984.

Indiana

Professional Licensing Agency

CAROL BRYAN BALLOU
Controlled Substance Registration - Physician
License number
01031895B
Date granted
09/01/1982
Date expires
12/31/1984
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1100 WEST SIXTH AVE, GARY IN 46402
indianalicensing.org
ID 5856303
LAST UPDATED 2024-05-10 18:34:46 UTC

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